Harmsen Hannah, Mobley Bret C, Davis Larry T
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA.
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA.
Radiol Case Rep. 2019 Mar 28;14(6):700-703. doi: 10.1016/j.radcr.2019.03.015. eCollection 2019 Jun.
Angiocentric glioma is a rare low-grade neoplasm of the central nervous system which typically presents with medication-refractory seizures in children and young adults. On magnetic resonance imaging, angiocentric glioma is classically T1 hypointense and T2/FLAIR hyperintense. We present the case of a 40-year-old male who had been followed by our institution for 17 years for management of epilepsy. Initial and repeat brain imaging showed an apparent region of cystic encephalomalacia in the right frontal lobe. In an attempt to control his seizures, the lesion was resected. Grossly, the cut surface of the specimen was characterized by multiple small cystic spaces. Microscopically, the lesion was composed of an infiltrative population of glial cells variably arranged in perivascular "pseudorosettes," nodules, and subpial "palisades." The final diagnosis was angiocentric glioma. This is the second reported case of an angiocentric glioma mistaken for encephalomalacia.
血管中心性胶质瘤是一种罕见的中枢神经系统低级别肿瘤，通常在儿童和年轻成年人中表现为药物难治性癫痫发作。在磁共振成像上，血管中心性胶质瘤典型表现为T1低信号和T2/FLAIR高信号。我们报告一例40岁男性患者，我院对其癫痫治疗进行了17年的随访。初次及重复脑部成像显示右额叶有一个明显的囊性脑软化区域。为控制其癫痫发作，对该病变进行了切除。大体上，标本的切面有多个小囊腔。显微镜下，病变由浸润性的胶质细胞组成，这些细胞以血管周围“假菊形团”、结节和软膜下“栅栏”等不同形式排列。最终诊断为血管中心性胶质瘤。这是第二例报道的血管中心性胶质瘤被误诊为脑软化的病例。
